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Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
Comparison of left atrial volume and function in non-dipper versus dipper hypertensives: A real-time
Necip Ermiş1, Yılmaz Ömür Otlu2, Abdülmecit Afşin3
1Department of Cardiology, Turgut Özal Medical Center, İnönü University, Malatya-Turkey. necipermis@yahoo.com.
Insights
Non-dipper hypertension is linked to larger left atrial (LA) volumes and altered passive LA function, as shown by real-time three-dimensional echocardiography (RT3-DE). These findings highlight potential adverse cardiac remodeling in non-dipper hypertensive patients.
Area of Science:
- Cardiology
- Echocardiography
- Hypertension Research
Background:
- Non-dipper hypertension is a significant risk factor for cardiovascular morbidity and mortality.
- Left atrial (LA) size and function are established prognostic indicators in cardiovascular diseases.
Purpose of the Study:
- To investigate the impact of non-dipper hypertension on left atrial (LA) volume and function.
- To utilize real-time three-dimensional echocardiography (RT3-DE) for precise assessment.
Main Methods:
- A prospective cross-sectional study involving 40 dipper and 52 non-dipper hypertensive patients.
- Exclusion of participants with comorbidities that could affect cardiac structure.
- Assessment of LA volumes and functions using two-dimensional echocardiography (2-DE) and RT3-DE.
Main Results:
- Non-dipper hypertensives exhibited significantly higher LA minimal volume, LA volume before LA contraction, and LA total systolic volume compared to dippers (p<0.001, p=0.003, p=0.03).
- Elevated interventricular septal thickness and E/Em ratio were observed in non-dipper hypertensives (p=0.001, p=0.03).
- Moderate correlations were found between LA volumes and E/Em ratio (r=0.31-0.32, p=0.005-0.007).
Conclusions:
- Non-dipper hypertension is associated with increased LA volume and impaired passive LA systolic function, as detected by RT3-DE.
- Active LA systolic function alterations were not prominent in this group.
- RT3-DE is a valuable tool for identifying LA remodeling in systemic hypertension.
Objective:
Non-dipper hypertension is associated with an increased cardiovascular morbidity and mortality. Besides this, the left atrial (LA) size and functions are accepted to be prognostic factors in various cardiovascular diseases. In this study, we aimed to evaluate the effect of nondipper hypertension on LA volume and functions using real-time three-dimensional echocardiography (RT3-DE).
Methods:
Forty dipper and 52 non-dipper hypertensives enrolled in this prospective cross-sectional study. Patients with any comorbidities that have a potential for causing structural cardiac alterations were excluded. Two-dimensional echocardiography (2-DE) and RT3-DE were performed to assess LA volumes and functions. The statistical tests used in this study were Shapiro-Wilk's test, Student's t-test, Mann-Whitney U test, chi-square test, Spearman's test, and Pearson's correlation test.
Results:
LA minimal volume, LA volume before LA contraction, and LA total systolic volume were higher in non-dipper hypertensives than in dipper hypertensives (p<0.001, p=0.003, and p=0.03, respectively). Only, the 2-DE measurements of interventricular septal thickness and E/Em ratio were higher in non-dipper hypertensives (p=0.001 and p=0.03, respectively). There was a moderate correlation between LA minimal volume and LA volume before LA contraction with E/Em (r=0.31, p=0.007 and r=0.32, p=0.005, respectively).
Conclusion:
Although LA volume and passive LA systolic functions measured by RT3-DE are significantly increased in non-dipper hypertensives, the alterations in active LA systolic functions are not prominent. RT-3DE may be used to define LA volume and function alterations in conditions that have capabilities of adverse cardiac remodeling such as systemic hypertension.
